Methods: We conducted a 6-month prospective trial for patients (6 months-21 years old) with persistent asthma presenting with an asthma exacerbation in the emergency department(ED). Participants (primary caregiver and child) were randomized to AsthmaCare (application providing medication/trigger reminders and electronic treatment plan) or control (online asthma information). Primary outcomes were health care utilization in the 6-month period before and after randomization. Secondary measures included baseline and 6-month follow-up caregiver surveys.
Results: In AsthmaCare (n=98) and control (n=95) groups, mothers primarily were responsible for medication administration (87% vs. 90%;respectively). Caregivers in both groups were similar in high health literacy (82% vs. 78%), and both lacked prior use of mobile health applications (90% vs. 92%). While most participants had received a written treatment plan (85% vs. 76%), they used them less than daily (78% vs. 83%).
Follow-up survey completion was similar (69% vs. 76%) in both groups. Reported improvement in asthma management was greater in AsthmaCare participants (79% vs. 62%;p=0.06), along with greater daily use of treatment plans (29% vs. 11%;p=0.01). Among those with high health literacy, AsthmaCare participants had a 73% reduction (26 vs. 10;p=0.02) and controls only 25% reduction (20 vs. 15;p =0.45) in urgent care visits. No differences were observed for ED visits/hospitalization.
Conclusions: Patients with higher health literacy may be more amenable to use of mobile health applications as a tool to augment asthma management.